Social Determinants Updates |
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September 16 to September 30, 2022
Welcome to Aligning for Health's bi-weekly Social Determinants Updates newsletter.
To add news or events to this newsletter, email info@aligningforhealth.org.
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Member News
UPMC Health Plan: UPMC for You Medicaid Plan Earns NCQA Health Equity Accreditation & Health Equity Accreditation Plus Designation (9/29) – UPMC Health Plan announced its Medicaid managed care plan, UPMC for You, earned Healthy Equity Accreditation and Health Equity Accreditation Plus status from NCQA, which recognized UPMC for You’s commitment to and results related to diversity, inclusion and equity for its employees and members.
CareSource: CareSource Launches Opportunity Investment Fund to Support Health and Community Initiatives in Iowa (9/28) – CareSource announced the launch of the CareSource Iowa Opportunity Investment Fund through a partnership with ISA Ventures. The fund will provide capital for Iowa-based startups that seek to improve health care outcomes, promote health equity, and generate positive social impact, especially for underserved populations and those with complex care needs.
EHR Intelligence: How a Michigan HIE is Working Towards SDOH Interoperability (9/28) – Michigan has been leading in work regarding social-related health needs and SDOH interoperability, in part because the state has been well-funded in the health information exchange (HIE) space. For example, MiHIN recently convened vendors including findhelp and Unite Us
to create an Interoperable Referrals Pledge, a commitment to enable a more interoperable social care environment through collaboration.
BCBSA:
New Report Finds Racial and Ethnic Disparities in Maternal Health Complications Climbed During COVID-19 Pandemic (9/21) – Blue Cross Blue Shield Association (BCBSA) released a report
that confirms women of color are at a higher risk of pregnancy-related complications, regardless of having commercial health insurance or Medicaid. The data indicates maternal health disparities are likely the result of broader health system and societal challenges, including underlying chronic conditions, racial inequities, and likely biases within the health system.
B-Time Podcast: The Impact of SDOH on Health with Unite Us Co-founder & CEO Dan Brillman (9/19) – This episode of the B-Time Podcast features Unite Us
Co-founder & CEO Dan Brillman, where he discusses social determinants of health and the impact of SDOH on health and health care costs. Brillman describes how Unite Us is connecting the community to address their health and social needs.
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Legislative Updates
Education and Training (EAT) for Health Act (9/22) – Reps. Grijalva (D-AZ) and McGovern (D-MA) introduced the Education and Training (EAT) for Health Act (H.R. 8964), which would increase nutrition education and awareness for health care professionals and ensure federal primary care health professionals have continuing education courses relating to nutrition.
House Ways & Means Committee: Neal, Brady Praise Committee Passage of Home Visiting and Mental Health Legislation (9/21) – The House Ways & Means Committee held a markup and advanced 14 home visiting and mental health bills. This included the Jackie Walorski Maternal and Child Home Visiting Reauthorization Act of 2022 (H.R. 8876), which passed by a vote of 41-0. The bill would reauthorize the Maternal, Infant, and Early Childhood Home Visiting program. The bill now heads to the full House for consideration. Bill Summary
Section-by-Section
House Committee on Veterans’ Affairs: Committee Votes to Send 13 Bills to House Floor (9/21) - The House Committee on Veterans’ Affairs held a markup and voted to advance 13 bills to the full House for consideration, including a number of health care bills. Notably, the Committee passed by voice vote the Food Security for All Veterans Act (H.R. 8888), which would establish in the VA an Office of Food Security, and the End Veteran Hunger Act of 2022 (H.R. 8852), which would direct the Secretary of the VA to carry out a pilot program on food insecurity.
To view a full list of the legislation we are tracking around social determinants of health, health equity/disparities, and maternal health, click here.
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Administration Updates
Journal of Public Health Management & Practice: Social Determinants of Health – An Approach Taken at CDC (9/28) – This journal, written by officials at CDC, outlines the steps the CDC has taken to ensure efforts to address SDOH that fall within CDC’s broader health equity strategy are built into the agency’s work and not confined to a single program, national center, or public health topic.
CMS: Financial Well-Being of Medicare Beneficiaries Data (9/28) – CMS announced the availability of a new public use file on financial well-being of Medicare beneficiaries. This public use file presents estimates on asset ownership, food insecurity, access to transportation, and access to the internet for Medicare beneficiaries living in the community who were enrolled in Medicare in 2020.
ASPE: Many Children in HHS Safety Net Programs are Eligible for Nutrition Assistance but are Not Enrolled (9/27) – The HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) released a report
analyzing children served by HHS safety net programs who were eligible but not enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP) in 2018. Thirty-nine percent of young children served by HHS safety net programs were eligible but not enrolled in WIC, while nine percent of children were eligible but not enrolled in SNAP.
Administration for Children & Families: HHS Announces New Diaper Distribution Pilot Program for Families in Need (9/27) – HHS announced the new Diaper Distribution Demonstration and Research Pilot program to distribute diapers to low-income families and help reduce their economic burden. As part of this new program, the Administration for Children and Families (ACF) will award $8 million in funding to Community Service Block Grant state associations and tribes to provide diapers and diapering supplies to families in need.
ASPE: Landscape of Area-Level Deprivation Measures and Other Approaches to Account for Social Risk and SDOH in Health Care Payments (9/26) – HHS ASPE released a report
examining three environmental scans of: area-level indices of social risk; measures used in government programs that target areas, providers, or populations with social risk; and existing payment models that incorporate measures of social risk. The report finds that there remains considerable heterogeneity in how social risk is measured.
HHS: HHS Announces HRSA-Funded Health Centers Partnering with National Cancer Institute-Designated Cancer Centers to Improve Equity in Cancer Screenings (9/23) – HRSA awarded over $5 million to 11 HRSA-funded community health centers to facilitate access to life-saving cancer screenings and early detection services for underserved populations to improve equity in cancer screenings.
CMS: HHS Approves 12-month Extension of Postpartum Medicaid and CHIP Coverage in NC (9/22) – CMS approved the extension of Medicaid and CHIP coverage for 12 months after pregnancy in North Carolina, meaning up to an additional 28,000 people will now be eligible for such coverage in the state.
NIH: NIH Collaboration Seeks to Help Understand US Burden of Health Disparities – Why Your County Matters (9/20) – In this new NIH Director’s blog, NIMHD Director Dr. Eliseo J. Pérez-Stable shares how an NIH research collaboration works towards understanding how geographic locations and disparities in these communities may play a role in health equity.
CDC: Pregnancy-Related Deaths – Data from Maternal Mortality Review Committees in 36 States, 2017-2019 (9/19) – The CDC released new data, showing that more than four in five pregnancy-related deaths in the U.S. could have been avoided, with mental health conditions listed as the most frequent underlying cause of pregnancy-related death.
HHS: HHS Awards $3M for Initiative to Promote Black Youth Mental Health (9/19) – HHS announced more than $3 million in grants to eight organizations for a new initiative to demonstrate policy effectiveness to promote Black youth mental health (BYMH). The three-year initiative will help identify health and wellness policies that are successful in improving BYMH, including suicide prevention.
CMS: New York Medicaid Redesign Team – Health Equity Reform Amendment Application Demonstration (9/19) – CMS announced that the federal comment period for New York’s section 1115 demonstration waiver amendment, which seeks $13.52 billion over five years to implement changes to address health equity, is open through October 19, 2022. The amendment
seeks to integrate social, physical health, and behavioral health into the state’s Medicaid program and to advance health equity.
HHS: HHS Awards More than $3.6M to Bolster Support, Training on SUD During Pregnancy and Postpartum (9/16) – The HHS Office of Women’s Health awarded more than $3.6 million in competitive grants to seven organizations working to bolster support for individuals experiencing substance use disorder (SUD) during pregnancy and postpartum. The Reducing Maternal Deaths Due to SUD grant program aims to strengthen perinatal and postpartum support structures and reduce deaths during these periods.
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Spotlight on Food Insecurity & Nutrition Following the White House Conference on Hunger, Nutrition, and Health
On September 28, the White House held the White House Conference on Hunger, Nutrition and Health. The goal of the conference is to end hunger and increase healthy eating and physical activity by 2030, so that fewer Americans experience diet-related diseases like diabetes, obesity, and hypertension. As part of this Conference, the White House announced the following actions:
- National Strategy on Hunger, Nutrition, and Health – The White House released a National Strategy which identifies goals and achievable actions across the federal government that the Biden Administration will pursue to drive transformation across five pillars to reach the goal of ending hunger and reducing diet-related diseases and disparities by 2030. An executive summary of the strategy can be found here.
- New Commitments for Action – The White House announced over $8 billion in new private and public sector commitments in response to the Conference, outlining a package of new actions that business, civic, academic, and philanthropic leaders will take to end hunger and reduce diet-related diseases. Several Aligning for Health members have made commitments through this effort.
Remarks by President Biden during the Conference can be found here.
Additional statements are available from Agriculture Secretary Tom Vilsack and Dr. Sara Bleich, Director of Nutrition Security and Health Equity, Food, and Nutrition Service at the US Department of Agriculture (USDA).
Below are a number of articles highlighting actions related to food insecurity, nutrition, and health in response to this Conference taking place:
CMS: HHS Approves Groundbreaking Medicaid Initiatives in MA and OR (9/28) – CMS approved groundbreaking Medicaid section 1115 demonstration initiatives in Massachusetts and Oregon, which will ensure children in Oregon have continuous Medicaid coverage until age six and expand access to coverage and address nutrition and housing needs in both states. The waivers support the goals of the White House Conference on Hunger, Nutrition, and Health, as the initiatives take steps to address unmet health-related social needs such as providing authority to test coverage for evidence-based nutritional assistance and medically tailored meals. MA Press Release
Kaiser Permanente: Improving nutrition, reducing hunger, advancing health (9/28) – Kaiser Permanente is committing $50 million to bolster programs that increase food and nutrition security and improve health outcomes for the country’s most vulnerable populations. The contribution also supports significant collaboration between public and private entities to develop solutions for ending hunger and improving health and health equity.
Fierce Healthcare: Grocery delivery company Instacart launches new health division to expand access to nutritious food (9/28) – Instacart launched a new business initiative
aimed at expanding access to nutritious food for underserved communities. Announced in collaboration with the White House Conference, Instacart plans to roll out new products, strategic partnerships, research and policy advocacy commitments to help increase food security, make food more affordable and make it easier for consumers to make healthier choices.
WBUR: Rep. McGovern says U.S. only needs ‘political will’ to end hunger by 2030 (9/28) – Rep. McGovern (D-MA) helped spearhead the White House Conference on Hunger, Nutrition and Health, and joined WBUR’s Morning Edition to discuss this effort. Rep. McGovern outlined his goals for the conference, why it is needed, and lessons from the COVID-19 pandemic on food and health in the U.S.
The Boston Globe: Rep. Jim McGovern’s mission to end hunger takes the spotlight at White House conference (9/27) – Rep. McGovern (D-MA) has been interested in the problem of food insecurity since he first interned for hunger relief advocate Senator George McGovern in the 1970s. They came to a shared goal to mobilize the federal government to end hunger in the U.S. Rep. McGovern has been a champion in Congress for the White House Conference on Hunger, Nutrition, and Health coming together, an issue he has been passionate about his entire career.
US Department of the Interior: Interior Department Advances Health and Nutrition Efforts Across Indian Country (9/27) – The Department of the Interior announced that the Bureau of Indian Affairs (BIA) and Bureau of Indian Education (BIE) will create Indigenous Food Hubs for BIE-operated schools and BIA-operated detention centers to help source Indigenous foods, enhance culturally based healthy nutrition education, and boost training for healthy and culturally appropriate food preparation.
The Journalist’s Resource: Food Insecurity and Food Deserts in the US – A Research Roundup and Explainer (9/27) - The food landscape in the U.S. has changed since the first White House Conference on Food, Nutrition, and Health was held 53 years ago. This article summarizes several studies that show the link between food insecurity and health and include resources for journalists.
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SDoH & Health Equity in the News
Health Affairs: To Improve Dual Eligibles’ Health, Create Targeted SDOH Funds and Increase Integration (9/27) – This article proposes a two-pronged approach to improve health status, health equity, and care coordination for enrollees dually eligible for Medicare and Medicaid: Target additional funding for more services to address D-SNP beneficiaries’ social determinants of health through supplemental benefits, and increase administrative alignment between Medicare and Medicaid to advance greater integration.
PR Newswire: BioNJ Announces the Launch of its Health Equity in Clinical Trials Initiative (9/27) – BioNJ announced the launch of its Health Equity in Clinical Trials Initiative, which will define concrete issues that can be remedied with impact, identify long-term interventions, support companies to improve equity and access in their clinical trials strategies, benchmark best practices and shape policy.
Managed Healthcare Executive: Medicaid Programs Start to Embrace Respite Care for Unhoused (9/19) – To address the problem of homelessness, hospitals and clinics sometimes give recuperating patients a public transit pass to use or tell them to rest at a public library. Patients without housing often return to the hospital emergency department or are readmitted to the hospital. The health outcomes are worse than for patients who have housing and the medical expenditures are higher. In response, community health centers, homeless shelters, hospitals and other organizations have launched 133 medical respite programs for homeless people in 35 states and D.C.
JAMA Health Forum: Optimizing Investment in Housing as a Social Determinant of Health (9/15) – Housing is now widely recognized to be an important social determinant, with governments and nonprofit organizations seeing health improvement as a key byproduct of housing initiatives and housing viewed as a valuable hub for coordinating services. However, there are significant impediments to the goal of achieving the optimal level of investment in affordable housing as an SDOH by both the public and private sectors.
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Data and Innovation
Journal of AHIMA: Leveraging RCM and Coding to Help Address the Health Equity Gap (9/26) – The challenge for many health care organizations that want to participate in new reimbursement models focused on achieving care parity is how to expand health care leaders’ view of health equity and SDOH to fully grasp the true reach of this vital data. Health care organizations’ coding and revenue cycle management (RCM) departments are already aggregating valuable information that can ultimately help identify and better understand inequities in care delivery and inform initiatives to improve health equity across patient populations.
Journal of AHIMA: Improve Patient Outcomes by Integrating SDOH Data into EHRs (9/18) - This article details information required for integration of SDOH data into electronic health records to build personalized treatment plans and develop successful SDOH programs that provide resources and support for patients in need. In addition, successful SDOH programs implemented by Kaiser Permanente and Boston Medical Center showcase how supporting clinicians with real-time SDOH data can lead to patient-centric care.
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New Research and Reports
JAMA Cardiology: Food Insecurity Among Individuals with Cardiovascular Disease and Cardiometabolic Risk Factors Across Race and Ethnicity in 1999-2018 (9/28) – This study looked at the 20-year prevalence of food insecurity among individuals with cardiovascular disease (CVD) or cardiometabolic risk factors, and whether this prevalence differed across racial and ethnic groups. Food insecurity increased over time for those with CVD and cardiometabolic risk factors and was more frequent among those with CVD. These disparities persisted across racial and ethnic groups and CVD presence.
The Permanente Journal: Engaging Stakeholders in SDOH Quality Improvement Efforts (9/26) – Despite their impact on health outcomes, it is not clear how to integrate SDOH into clinical practice and health care policy. This quality improvement project engaged stakeholders to identify SDOH factors relevant in an Alaska Native/American Indian health system and how to integrate SDOH data into electronic health records.
Milbank Memorial Fund: SDOH Influences Future Health Care Costs in the Medicaid Cohort of DC (9/22) - Social determinants of health are an important predictor of future health care costs, but little is known about their impact on Medicaid spending. This study analyzes the role of SDOH in predicting future health care costs for adult Medicaid beneficiaries in Washington, D.C. with similar past morbidity burdens and past costs.
Journal of the National Cancer Institute: Housing Insecurity Among Patients with Cancer (9/21) - In 2021, the National Cancer Policy Forum sponsored a series of webinars addressing SDOH and their associations with cancer care and patient outcomes. This commentary summarizes the formal presentations and panel discussions devoted to housing insecurity. It provides an overview of housing insecurity and health care across the cancer control continuum, describes health system interventions to minimize the impact of housing insecurity on patients with cancer, and identifies challenges and opportunities for addressing housing insecurity and improving health equity.
JAMA Network Open: Prevalence and Risk Factors for Medical Debt and Subsequent Changes in SDOH (9/16) – This study looked at the prevalence and risk factors associated with medical debt in the U.S. Over three years, decreases in health status and coverage loss were significant risk factors associated with acquiring medical debt, which was, in turn associated with a significant 1.7-fold to 3.1-fold higher risk of worsening housing and food security.
LISC: Medicaid as a Multiplier (September 2022) – LISC released a report
showing how Medicaid can fund community interventions to improve the social determinants of health. The model is paving the way for community-based organizations to collaborate with hospitals and insurers to promote health equity and lower health care costs. The report examines Medicaid-funded partnerships that address SDOH and the role of community development intermediaries in advancing them.
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Aligning for Health Holds Webinar on Coordinating Funding & Data to Address SDOH
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Aligning for Health held a briefing highlighting programs and best practices on coordinating funding and data to address social determinants of health, featuring perspectives and examples from the federal government, state and local leaders, and their partners.
Opening Remarks were provided by Dr. Sandra Ford, Special Assistant to the President for Public Health and Science at the White House. Guest Panelists Included:
- Erica Coletti, CEO, Healthy Alliance
- Sue Polis, Director, Health & Wellness, National League of Cities
- Amy Riegel, Executive Director, Coalition on Homelessness & Housing in Ohio (COHHIO)
Panelist bios can be found here. The slides from the webinar can be found here. Additional resources and the recording can be found here.
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Upcoming Events
September
October
November/December
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SDoH Opportunities
October
November/December
Rolling Basis & 2023
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